Can Vyvanse (lisdexamfetamine) cause acne or other skin issues?

Vyvanse and Skin Issues

Vyvanse (lisdexamfetamine) can cause skin issues, but acne is not a commonly reported adverse reaction in clinical trials or FDA labeling. The most frequently documented dermatologic adverse reaction is rash, which occurred in 1% of pediatric patients in controlled trials 1.

What the FDA Label Shows

According to the official FDA prescribing information, the dermatologic adverse reactions documented in clinical trials include:

• Rash: Reported in 1% of pediatric patients (ages 6-12), occurring at twice the rate of placebo 1
• Dermatillomania (skin picking): Reported as a less common adverse reaction leading to discontinuation in adolescents 1
• Hypersensitivity reactions: Anaphylactic reactions, Stevens-Johnson Syndrome, angioedema, and urticaria have been observed in post-marketing reports 1

Acne is not listed among the adverse reactions in any of the controlled clinical trials or FDA safety data 1.

Rare Case Reports

One recent case report from 2025 documented severe angioedema and leukocytoclastic vasculitis (a type of blood vessel inflammation affecting the skin) in a 57-year-old male after starting lisdexamfetamine, confirmed by positive rechallenge 2. This represents a rare hypersensitivity reaction rather than typical acne.

Important Context About Drug-Induced Acne

While stimulant medications are not typically associated with acne, true drug-induced acne has specific characteristics that differ from typical acne vulgaris 3:

• Sudden onset after starting medication
• Monomorphic inflammatory papules or papulopustules (all lesions look similar)
• Location beyond typical seborrheic zones (face, chest, back)
• Unusual age of onset

The drugs most commonly associated with acne include corticosteroids, anabolic steroids, testosterone, halogens, isoniazid, lithium, and certain anticancer agents—not stimulants like Vyvanse 3.

Clinical Recommendation

If a patient on Vyvanse develops new skin issues:

1. Evaluate the timing: Did the skin problem start shortly after initiating Vyvanse?
2. Assess the morphology: Does it look like typical acne vulgaris or a drug rash (monomorphic, widespread)?
3. Consider alternative causes: Adolescents commonly develop acne independent of medications
4. If true acne vulgaris develops: Treat according to standard acne guidelines with topical retinoids, benzoyl peroxide, or other appropriate therapies 4—do not automatically discontinue Vyvanse
5. If hypersensitivity reaction suspected (urticaria, angioedema, widespread rash): Discontinue Vyvanse and evaluate for alternative ADHD medications 1

The bottom line: Standard acne vulgaris occurring in a patient taking Vyvanse is likely coincidental and should be treated with evidence-based acne therapies rather than attributed to the medication. True drug-induced skin reactions from Vyvanse are rare and typically present as rash or hypersensitivity reactions, not acne.